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Oct 23, 2011

Watery Leakage Every Morning - Seeking Advice for Ileostomy-related Issue

This topic is about a person who has been experiencing a mysterious morning leakage after undergoing a sub-total colectomy and later a permanent ileostomy. Despite consulting several doctors, the cause of this clear, odorless liquid that appears on their lower back remains unidentified. Here are some insights and advice that might be helpful:

1. It's not uncommon to have clear or slightly bloody mucus or drainage from the anal or perianal area after surgeries like colectomy or ileostomy. People with Crohn’s disease often report similar issues because the tissue doesn't heal well.

2. Managing your diet and fluid intake can help reduce overall output and related leakage:
- Try to limit your liquid intake to about three glasses a day, avoid carbonated drinks, and skip using straws to reduce gas and pressure.
- Look into resources like the Mayo Clinic website to understand how different foods affect you. Adjusting your diet by removing trigger foods and adding others has helped some people reduce bowel frequency and diarrhea.

3. After large-bowel removal, bladder displacement can cause sporadic urination and repeated urinary tract infections (UTIs). One person found that using topical estrogen vaginal cream helped eliminate recurrent UTIs.

4. Minor seepage from the anal stump is often considered medically harmless. Some surgeons suggest protecting your clothing and skin rather than opting for further surgery:
- Using mini-pads or leak pads in your underwear can help catch small amounts of fluid or pink staining.

5. If you have persistent weeping or "tears" in the perianal skin, consider these treatments:
- Clean the area gently, as over-cleaning might make it worse.
- Start with applying an antibiotic ointment.
- A special "mud" containing tar, available through compounding pharmacies, was reported to stop the weeping and promote healing.

6. If the source of the seepage is still unclear, consider asking for further assessment. This could involve checking for possible glandular leaks, residual rectal stump secretions, or small fistulae. A referral to dermatology or colorectal surgery, along with imaging, might provide more answers.
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